The Hawaii Department of Health this afternoon said it has has identified two additional cases of monkeypox. This brings the total number of cases to eight.

One of the two new cases is a Hawaii island resident with a history of travel to the mainland. The second newly reported case is an Oahu resident, as were six earlier cases.

Connections of these two new cases to the previously reported cases are under investigation, DOH said.

“The risk to most Hawaii residents remains low, but with the number of cases growing across the country, we expect to identify more cases in Hawaii,” said Deputy State Epidemiologist Dr. Nathan Tan in a news release. “We understand a fair amount about how monkeypox spreads — primarily through close, intimate contact. DOH continues to conduct case investigation, coordinate vaccination and treatment, and work with healthcare providers across the state.”

DOH also continues to conduct contact tracing and coordinate vaccination and treatment, which are available in the state, and which can be effective in managing monkeypox infections.

At this time, DOH said Hawaii’s limited allocation of Jynneos vaccines is being offered to close contacts of people known to have monkeypox, and for people who may have had high-risk exposures in venues or areas where monkeypox is actively spreading.

DOH is arranging statewide vaccine distribution and administration, but vaccines are not available through health care providers at this time.

Monkeypox is a rare disease caused by the monkeypox virus, which is in the same family of viruses as smallpox, according to the Centers for Disease Control and Prevention.

Infection often begins with flu-like symptoms such as fever, headache, muscle aches, chills, exhaustion and swollen lymph nodes in the neck, underarm or groin area, and this is oftentimes followed by rashes or sores on the hands, feet, chest, face, or genitals.

However, some people get a rash first, followed by other symptoms, according to CDC, while others only experience a rash.

Individuals generally become ill within 21 days of exposure.

While most people diagnosed with monkeypox experience mild to moderate illness, the rash and sores can be itchy and painful, health officials said.

Monkeypox is mainly spread through close, intimate contact with body fluids, rashes and sores, or items used by someone with monkeypox.

Monkeypox may also be spread through large respiratory droplets, health officials said, but these droplets generally cannot travel more than a few feet, so prolonged face-to-face contact is required.

Monkeypox cases nationwide also continue to grow. CDC as of today confirmed 1,814 monkeypox and orthopoxvirus cases across the U.S., in more than 40 states, the District of Columbia and Puerto Rico.

The current cases are primarily spreading among social networks of gay, bisexual, and other men who have sex with men nationwide, said DOH. In Hawaii, at least some of the cases have been reported among gay or bisexual men.

However, anyone who has close contact with someone with monkeypox is at risk of infection, regardless of sexual orientation or gender identity. Anyone with monkeypox symptoms should contact their health care provider immediately.